Provider Demographics
NPI:1861645715
Name:BUTLER, HARVEY EUGENE III (DMD)
Entity Type:Individual
Prefix:DR
First Name:HARVEY
Middle Name:EUGENE
Last Name:BUTLER
Suffix:III
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:304 79TH AVE N
Mailing Address - Street 2:
Mailing Address - City:MYRTLE BEACH
Mailing Address - State:SC
Mailing Address - Zip Code:29572-4304
Mailing Address - Country:US
Mailing Address - Phone:843-449-4812
Mailing Address - Fax:843-449-3632
Practice Address - Street 1:304 79TH AVE N
Practice Address - Street 2:
Practice Address - City:MYRTLE BEACH
Practice Address - State:SC
Practice Address - Zip Code:29572-4304
Practice Address - Country:US
Practice Address - Phone:843-449-4812
Practice Address - Fax:843-449-3632
Is Sole Proprietor?:No
Enumeration Date:2008-10-23
Last Update Date:2008-10-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC29771223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice